Private Health Insurance - Do I Need It For Surgery?
Insured
Most health funds cover bariatric (weight-loss) surgery, however, you will usually need to be in a high level of cover.
Patients with an appropriate level of private health insurance cover will find most hospital and equipment charges will incur a “no gap” fee. The out of pocket expenses for insured patients relate mostly to professional and clinic fees charged by the surgeon, anaesthetist and their assistants. Occasionally, in your operation, there may be certain equipment used which is “non-rebateable,” such as the lap band device.
To check, simply contact your health fund and quote the relative surgery ‘item numbers’ listed.
Sleeve Gastrectomy
Item No. 31575
Gastric Band
Item No. 31569
Gastric Bypass
Item No. 31572
Revisional Surgery
- Band to Sleeve (Single Stage)
Item No. 31584
- Band to Bypass (Single Stage)
Item No. 31584
- Band to Sleeve (2 Stage)
Item No. 31585, 31584
- Band to Bypass (2 Stage)
Item No. 31585, 31584
Uninsured
If you are NOT INSURED for weight loss surgery, we have multiple payment options for you. This includes:
Affordable Payment Plans
Early Release of Superannuation
Procure/Upgrade Private Health Insurance
Self-funded
Affordable Payment Plans
We understand the financial pressure associated with having weight loss surgery and to assist with this, we have partnered with TLC (Total Lifestyle Credit) to offer affordable payment plans.
Please call our friendly team on 03 9895 7215 to discuss how TLC's payment plans can work for you!
Procure/Upgrade Private Health Insurance
You may choose to procure or, upgrade your level of Private Health Insurance which will generally incur a 12-month waiting period. To qualify for weight loss surgery, you will usually require top/gold level cover. Once you have made the decision to have weight loss surgery, there are many things that can be done to prepare.
Here at NEWLS, we can help set out an individual plan to help make the most of any private insurance waiting periods so you are ready to go once insurance is good.
Early Release of Superannuation
Gaining access to your superannuation to undergo surgery is an option. There are, however, a few things that should be carefully considered prior to accessing your super that may/will affect your retirement income.
When money is withdrawn from your superannuation account, the government will apply a 20% tax on the amount requested e.g. if $10,000 is requested, $12,000 will be deducted - $2,000 will be the tax you must pay. Any funds that are withdrawn also need to be added to your end-financial year taxable income for taxation purposes. This may push some people into the next taxation bracket and you may find that you will need to repay money to the ATO. The extra funds can also affect Centrelink payments (eg. family tax benefit, parenting payments & childcare funding) and you may find you have been overpaid or, are no longer eligible.
Accessing superannuation should be carefully considered and NEWLS always recommends seeking financial advice to discuss personal financial circumstances/tax implications.
For more information on accessing your super early, visit the NEW LINK on the ATO site (updated 20-21 June 2018):
In some circumstances, after the initial consultation and discussion with the surgeon, self-funding may be considered. Self-funding is an option for those who want to pay for surgery immediately and don't want to apply for private health insurance and incur waiting periods. As a self-funding patient, you will be responsible for all hospital costs prior to admission and these are not covered by Medicare.
Costs include (but are not limited to): • Hospital Fees • Theatre Fees • Surgical Equipment • Pathology/Radiology Fees • Professional Fees (Surgeon, Assistant & Anaesthetist Fees)
Medicare rebates apply to surgeon & anaesthetist fees after the surgery has been performed. Subsequent appointments within the clinic will attract a fee that is rebateable from Medicare.
*High-risk patients and those seeking revisional surgery will not be considered without private health insurance.
Weight Loss Surgery Cost can vary depending on the type of procedure and whether you are having it done in a public or private hospital. At our weight loss clinic in Melbourne, we offer a range of affordable weight loss procedures such as gastric sleeve surgery, gastric bypass surgery, lap band surgery, and revision surgery. For patients with private health insurance, some of the costs may be covered, but there may still be out-of-pocket costs to consider. Surgery fees can also depend on your BMI and whether you have any other medical conditions such as sleep apnoea or a hernia. Before undergoing any bariatric surgery, it's important to consult with a GP and a dietitian to discuss the best options for your weight loss journey.
At our clinic, we have a surgical assistant who can guide you through the process and provide you with the necessary information about gastric surgery cover and insurance options. If you do not have insurance, contact us to discuss payment plans and affordable weight loss surgery options. General surgery prices for revision surgery and post-surgery care can also be provided upon request. Our team in Melbourne is dedicated to helping patients achieve their weight loss goals in a safe and cost-effective manner.
When considering weight loss surgery costs, it's important to note that the item number for the procedure may affect the overall price. With the help of our experienced surgical team, you can rest assured that you are in good hands throughout your weight loss journey. Whether you are insured or uninsured, we are here to support you every step of the way and ensure that you receive the best possible care for your medical needs.
The cost of bariatric surgery can vary depending on the type of procedure, hospital fees, and post-operative care. On average, bariatric procedures, including gastric sleeve and bypass, can range from $15,000 to $30,000.
Health insurance may cover bariatric surgery if specific criteria are met, such as medical necessity due to obesity-related health issues. It's important to check with your insurance provider to understand what is covered and any required policies.
Yes, there can be additional costs, including follow-up appointments, post-operative care, and potential hospital excess fees. Patients should also consider the cost of nutritional supplements and support services.
The best type of bariatric surgery depends on individual health needs and medical history. Common types include gastric sleeve, gastric bypass, and adjustable gastric banding. Consulting with a bariatric surgeon can help determine the most suitable option.
Services included typically cover pre-operative consultations, the surgical procedure itself, hospital stay, and immediate post-operative care. Some programs also offer additional support services like nutritional counselling and follow-up care.
Billing for bariatric surgery usually involves the hospital, the surgeon, and any additional service providers. It’s essential to ensure that all billed expenses are clearly itemised and understand what portions are covered by insurance or may require out-of-pocket payment.
Post-operative care is crucial for recovery and may include follow-up appointments, monitoring for complications, and support for dietary changes. Patients often require ongoing support to ensure successful weight loss and health maintenance.
Medicare and some health funds may cover part of the costs for bariatric surgery, depending on the patient's eligibility and specific health plan. It's advisable to contact Medicare or your health fund provider for detailed information.
Follow-up care is vital to monitor progress, manage any complications, and provide nutritional support. Regular appointments with healthcare providers help ensure the best outcomes from the surgery.
Some hospitals and clinics offer financing plans or payment programs to help manage the cost of bariatric surgery. Additionally, checking with insurance providers about policy coverage can significantly reduce out-of-pocket expenses.
Factors influencing the cost include the type of surgery, the surgeon's experience, hospital fees, geographic location, and the extent of post-operative care required. Insurance coverage and additional health support services also play a role.
